Isolated Atrial Septal Defect Complicated by Tricuspid Valve Infective Endocarditis

Shimbo, Mai; Watanabe, Hiroyuki; Abe, Takuzo; Sato, Takeya; Koyama, Takashi; Yamamoto, Hiroshi; Itoh, Hiroshi

doi:10.2169/internalmedicine.54.4233

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…Due to the slow shunt speed, the risk of IE from ASD was negligible, and it did not predispose the patient to IE. Therefore, IE associated with ASD is extremely rare, and only a few previous reports exist in the literature [23,24]. For this reason, we initially ignored the possibility of IE in the present case.…”

Section: Discussionmentioning

confidence: 95%

Recurrent peritonitis relapse in a patient with atrial septal defect undergoing peritoneal dialysis: a case report

Sun

2022

BMC Nephrol

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Background Peritonitis is the most common complication in patients undergoing peritoneal dialysis (PD). Most patients recover with appropriate antibiotic treatment; however, when peritonitis repeatedly relapses, the cause of recurrence must be explored. The relationship between atrial septal defect (ASD), infective endocarditis (IE), and peritonitis is rarely reported. Here, we present a case of recurrent peritonitis due to Staphylococcus aureus in a patient with ASD and IE undergoing PD. Case presentation A 46-year-old woman with chronic renal failure secondary to chronic glomerulonephritis experienced three episodes of peritonitis within 80 days of starting PD. The patient had a history of untreated ASD without symptoms. After undergoing PD for approximately 35 days, the patient was admitted to our hospital on April 5, 2016, due to abdominal pain and fever for 1 week (maximum temperature of 38.5 °C) accompanied by chills and shivering. The PD effluent from the time of her admission was positive for S. aureus. Thereafter, peritonitis recurred each month. When the third episode of peritonitis occurred, transthoracic echocardiography was performed, and a vegetation measuring 9.5 × 6.4 mm attached to the surface of the right ventricle around the ventricular septal membrane was identified. Finally, the patient was diagnosed with IE. Then, ASD repair surgery was successfully performed after the infection was controlled. The patient was followed up for 5 years, with no further episodes of recurrence. Conclusions When a patient with ASD undergoing PD develops peritonitis, especially relapsing peritonitis, the possibility of IE is significantly increased. ASD repair surgery may be an important contributing factor to prevent peritonitis recurrence.

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Section: Discussionmentioning

confidence: 95%

Recurrent peritonitis relapse in a patient with atrial septal defect undergoing peritoneal dialysis: a case report

Sun

2022

BMC Nephrol

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“…○ Endocarditis in the presence of atrial septal defects is extremely rare due to the slow velocity of the shunt flow, and only few reported cases exist in the literature. An explanation of such occurrence could be related to the development of tricuspid regurgitation secondary to right ventricular volume overload which increases the risk of TV involvement [17].…”

Section: Risk Factorsmentioning

confidence: 99%

Surgery for Tricuspid Valve Endocarditis in the Current Era

Said¹

2021

Advanced Concepts in Endocarditis - 2021

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Tricuspid valve endocarditis (TVE) continues to be on the rise and has been mostly attributed to the growing epidemic of intravenous drug abuse (IVDA). Other risk factors include long-term indwelling central venous catheters and implantable cardiac devices. While medical management continues to be the first line therapy, surgery is indicated when medical management fails, and in the presence of hemodynamic deterioration, recurrent septic pulmonary embolization and/or persistent sepsis. Tricuspid valve (TV) excision once was the main surgical strategy, but other options include TV repair/reconstruction and replacement. Remaining challenges include management of drug-induced endocarditis and the best strategy for recurrent infection.

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Isolated Atrial Septal Defect Complicated by Tricuspid Valve Infective Endocarditis

Cited by 2 publications

References 9 publications

Recurrent peritonitis relapse in a patient with atrial septal defect undergoing peritoneal dialysis: a case report

Recurrent peritonitis relapse in a patient with atrial septal defect undergoing peritoneal dialysis: a case report

Surgery for Tricuspid Valve Endocarditis in the Current Era

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